Do you use mesh reinforcement of the cruroplasty when performing antireflux and hiatal hernia surgery?
Dear Dr Faour
To be honest there are no solid rules for using the mesh in hiatal hernia repair! The only concerns I believe are the risk of bleeding if you have to do redo hiatal hernia repair if a mesh was used in prior operation! and also the possibility of erosions.
I would say the majority of the surgeons here in the States use it but NOT routinely.
The preferred type now is absorpable .
Personally I would rather use it for larger defects.
I hope my answer helped, I am happy to see what other colleagues think as well, or what is you experience in that?
Dear Dr Faour,
Its not a routine to use a mesh if not strongle recommeded as in case of large defects to avoid recurrences .
I use a absorbable Mesh (Bio A from Gore) when the defect is larger than 5cm2
No I always worry about mesh around the Oesophagus for erosions and have done a number of re-do operations where mesh was supposedly used before and found no evidence of it but a large defect. I don’t believe mesh should be a substitute for a good crural repair
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